Global cholera deaths climbed 30% in 2025 to reach 7,870 fatalities, marking the highest annual death toll reported to the World Health Organization since 1999, according to surveillance data released in the Weekly Epidemiological Record. Despite the surge in deaths, reported infections dropped 20% year-over-year to 451,499 cases across 47 affected countries.
Concentration of Cases in Seven Conflict-Affected Nations
Just seven countries accounted for approximately 90% of all reported cholera cases and deaths globally in 2025: Angola, Bangladesh, the Democratic Republic of Congo, Nigeria, South Sudan, Sudan, and Yemen. The World Health Organization noted that every single one of these seven nations recorded conflict- or disaster-related displacement during the year, compounding challenges tied to inadequate sanitation and limited access to clean water.
The WHO African Region bore the heaviest burden, registering a 34% increase in cases and a 58% increase in deaths compared to 2024 figures. While oral cholera vaccine production more than doubled between 2022 and 2025—rising from roughly 30 million to 80 million annual doses—delivery hurdles persist. The International Coordinating Group on Vaccine Provision approved 71 million doses last year, which included 20 million doses designated for preventive campaigns that resumed earlier this year after being suspended for more than three years.
Barriers to Care and Treatment Gaps
Although cholera remains treatable with oral rehydration solutions, intravenous fluids, and antibiotics, rapid intervention is essential to prevent fatal dehydration. Data shows that more than one in five reported cholera deaths occurred outside of healthcare facilities, indicating that many patients fail to reach medical centers in time. For individuals treated within healthcare settings, the global case-fatality rate remained below 1%, though 12 countries still exceeded that 1% threshold in 2025.
“No one should be dying from cholera today when we have the tools to prevent and treat this disease,” said Chikwe Ihekweazu, MD, executive director of the WHO’s Health Emergencies Programme, in a news release. “The concentration of cases and deaths in a small number of countries shows where targeted investments in safe water, sanitation and hygiene could have the greatest impact.”
Meningitis and Plague Trends
Alongside the cholera update, the World Health Organization reported a decline in bacterial meningitis cases across Africa’s meningitis belt. In 2025, 24 of 26 countries reported 21,526 cases, representing a 6% drop from the previous year. Reported deaths from bacterial meningitis fell 30% to 971, resulting in a case-fatality rate of 4.5%.
The organization also tracked human plague data spanning from 2019 through 2025. During that window, 10 countries reported 3,847 suspected cases and 423 deaths, yielding an 11% case-fatality rate, with the Democratic Republic of Congo and Madagascar accounting for the majority of cases.
Related reading